Electrophysiological Effects of atrial Natriuretic Peptide on the Cardiac Conduction System in Man

We assessed the effect of atrial natriuretic peptide (ANP) on electrophysiological parameters in man. Electrophysiological parameters were measured before, at 15, and at 30 minutes after the commencement of ANP or placebo infusions (six patients in each group). ANP levels were normal prior to infusion and rose with ANP to 159 ± 43 pmol/L, but were stable during placebo infusion. No change in heart rate or blood pressure occurred in either group. ANP infusion resulted in significant falls in intraatrial conduction time (60 ± 15 to 49 ± 15 msec), PR interval (170 ± 21 to 155 ± 16 msec), right atrial effective refractory period (232 ± 33 to 218 ± 33 msec), and ventriculoatrial refractory period (452 ± 148 to 393 ± 183 msec) while no change was seen with placebo. We conclude that ANP infusion appears to affect atrial refractoriness and velocity of conduction and atrioventricular nodal refractoriness. However, the mechanism of action and clinical significance of this observation remain to be determined.